宿主因子与干扰素γ释放试验中的虚假负结果相关,该试验用于活跃结核病的成年人
Quanxian Liu1,2, Xukun Yang1, Jiayu Wen1
1Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China.
Heliyon
|December 14, 2023
概括
年龄较大,抗结核治疗时间较长,艾滋病毒感染,结缔组织疾病和低血红蛋白增加了干扰素γ释放测试 (IGRA) 对活性结核的假阴性结果.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 干扰素γ释放测试 (IGRA) 对于诊断结核病 (TB) 是至关重要的.
- 活跃结核病的假阴性IGRA结果可能导致诊断和治疗延迟.
- 识别与假阴性相关的因素对于提高诊断准确性至关重要.
研究的目的:
- 确定与成年人患有活跃结核病的假阴性IGRA结果相关的宿主因素.
- 为了提高在特定患者群体IGRA的解释.
主要方法:
- 对943名活跃结核病患者的临床数据进行了回顾性分析.
- 患者被分为IGRA阴性 (假阴性) 和IGRA阳性组.
- 后勤回归用于识别与IGRA消极性的关联.
主要成果:
- 18.5%的活跃结核病患者有假阴性IGRA结果.
- 假阴性IGRA的独立风险因素包括年龄较大,抗结核治疗>1个月,艾滋病毒感染,结缔组织疾病和低血红蛋白.
- 低血红蛋白与增加假阴性概率的轻微关联.
结论:
- 老年,长期的抗结核治疗,艾滋病毒共感染,结缔组织疾病和低血红蛋白是虚阴性IGRA结果导致活跃结核病的重要危险因素.
- 对于具有这些特征的成年结核病患者,建议仔细解释IGRA.
- 这些发现可以帮助临床医生更有效地管理结核病诊断.
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